American Society of Hirudotherapy

Nonreplantable total scalp avulsion reconstruction with acellular biologic matrix

Case report published in J Craniofac Surg (2022)

Last Updated: June 18, 2026Reviewed by: ASH Editorial Board
Research article — evidence reviewArticle reference
Evidence: Case reportClinical TrialsAnderson et al. · The Journal of craniofacial surgery, 2022

Abstract

Total scalp avulsion is a significant injury typically occurring as a result of industrial accidents involving high-speed rotary machines. Although ideal, scalp replantation is uncommon secondary to the nature of the injury and lack of viable microvas-cular anastomosis targets. Therefore, these defects are often reconstructed with microvascular free tissue transfer, with or without skin grafting. We present a unique case of a patient with total scalp avulsion achieving complete, stable skin coverage over partially intact periosteum using only spare parts of the amputated scalp as a temporary full-thickness graft and porcine urinary bladder matrix, thus, avoiding significant donor site morbidity or extensive surgery. At 4 years postoperative, the scalp coverage remains stable.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Publication typeCase ReportsJournal Article
Indexed MeSH termsAmputation, TraumaticAnimalsBiological ProductsScalpSkin TransplantationSwine

Summary

Total scalp avulsion deemed nonreplantable reconstructed with acellular biologic matrix as alternative to microsurgical replantation.

Why This Matters for Hirudotherapy

This case report presents a patient with total scalp avulsion reconstructed using amputated scalp fragments as temporary full-thickness grafts combined with porcine urinary bladder matrix, achieving complete and stable skin coverage at four years without significant donor site morbidity or extensive surgery. The abstract focuses on the use of a biological matrix for wound coverage in a context where microvascular replantation is uncommon due to the nature of the injury. There is no mention of leeches, hirudotherapy, hirudin, or leech-derived compounds. The article has no direct relevance to ASH's domain.

Citation

Nonreplantable total scalp avulsion reconstruction with acellular biologic matrix.

Anderson et al. · The Journal of craniofacial surgery, 2022

Added to ASH library: May 27, 2026 · Site last updated: June 18, 2026

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